The Globalization Of Eating Disorders Essay

This is a wonderful short essayby Susan Bordo which was originally posted by Patsy Clairmont on her blog:

Butterflies are just around the corner… adventures of a starving artist.

It is so interesting, insightful and filled with common sense, I just had to re-print it here.

“The young girl stands in front of the mirror. Never fat to begin with, she’s been on a no-fat diet for a couple of weeks and has reached her goal weight: 115 lb., at 5′4″–exactly what she should weigh, according to her doctor’s chart. But in her eyes she still looks dumpy. She can’t shake her mind free of the “Lady Marmelade” video from Moulin Rouge. Christina Aguilera, Pink, L’il Kim, and Mya, each one perfect in her own way: every curve smooth and sleek, lean-sexy, nothing to spare. Self-hatred and shame start to burn in the girl, and envy tears at her stomach, enough to make her sick. She’ll never look like them, no matter how much weight she loses. Look at that stomach of hers, see how it sticks out? Those thighs–they actually jiggle. Her butt is monstrous. She’s fat, gross, a dough girl”.

As you read the imaginary scenario above, whom did you picture standing in front of the mirror?

If your images of girls with eating and body image problems have been shaped by People magazine and Lifetime movies, she’s probably white, North American, and economically secure. A child whose parents have never had to worry about putting food on the family table. A girl with money to spare for fashion magazines and trendy clothing, probably college-bound.

If you’re familiar with the classic psychological literature on eating disorders, you may also have read that she’s an extreme “perfectionist” with a hyper-demanding mother, and that she suffers from “body-image distortion syndrome” and other severe perceptual and cognitive problems that “normal” girls don’t share. You probably don’t picture her as black, Asian, or Latina.

Read the description again, but this time imagine twenty-something Tenisha Williamson standing in front of the mirror.

Tenisha is black, suffers from anorexia, and feels like a traitor to her race. “From an African-American standpoint,” she writes, “we as a people are encouraged to embrace our big, voluptuous bodies. This makes me feel terrible because I don’t want a big, voluptuous body! I don’t ever want to be fat–ever, and I don’t ever want to gain weight. I would rather die from starvation than gain a single pound.”

Tenisha is no longer an anomaly. Eating and body image problems are now not only crossing racial and class lines, but gender lines. They have also become a global phenomenon.

Fiji is a striking example. Because of their remote location, the Fiji islands did not have access to television until 1995, when a single station was introduced It broadcasts programs from the United States, Great Britain, and Australia. Until that time, Fiji had no reported cases of eating disorders, and a study conducted by anthropologist Anne Becker showed that most Fijian girls and women, no matter how large, were comfortable with their bodies. In 1998, just three years after the station began broadcasting, 11 percent of girls reported vomiting to control weight, and 62 percent of the girls surveyed reported dieting during the previous months.

Becker was surprised by the change; she had thought that Fijian cultural traditions, which celebrate eating and favour voluptuous bodies, would “withstand” the influence of the media images. Becker hadn’t yet understood that we live in an empire of images, and that there are no protective borders.

In Central Africa, for example, traditional cultures still celebrate voluptuous women. In some regions, brides are sent to fattening farms to be plumped and massaged into shape for their wedding night. In a country plagued by AIDS, the skinny body has meant–as it used to among Italian, Jewish, and black Americans–poverty, sickness, death.

An African girl must have hips,” says dress designer Frank Osodi. “We have hips. We have bums. We like flesh in Africa.” For years, Nigeria sent its local version of beautiful to the Miss World competition. The contestants did very poorly. Then a savvy entrepreneur went against local ideals and entered Agbani Darego, a light-skinned, hyper-skinny beauty. (He got his inspiration from M-Net, the South African network seen across Africa on satellite television, which broadcasts mostly American movies and television shows.) Agbani Darego won the Miss World Pageant, the first Black African to do so. Now, Nigerian teenages fast and exercise, trying to become “lepa”–a popular slang phrase for the thin “it” girls that are all the rage. Said one: “People have realized that slim is beautiful.”

How can mere images be so powerful? For one thing, they are never “just pictures,” as the fashion magazines continually maintain (disingenuously) in their own defence. They speak to young people not just about how to be beautiful but also about how to become what the dominant culture admires, values, rewards. They tell them how to be cool, “get it together,” overcome their shame. To girls who have been abused they may offer a fantasy of control and invulnerability, immunity from pain and hurt. For racial and ethnic groups whose bodies have been deemed “foreign,” earthy, and primitive, and considered unattractive by Anglo-Saxon norms, they may cast the lure of being accepted as “normal” by the dominant culture.

In today’s world, it is through images–much more than parents, teachers, or clergy–that we are taught how to be. And it is images, too, that teach us how to see, that educate our vision in what’s a defect and what is normal, that give us the models against which our own bodies and the bodies of others are measured. Perceptual pedagogy: “How to Interpret Your Body 101.” It’s become a global requirement.

I was intrigued, for example, when my articles on eating disorders began to be translated, over the past few years, into Japanese and Chinese. Among the members of audiences at my talks, Asian women had been among the most insistent that eating and body image weren’t problems for their people, and indeed, my initial research showed that eating disorders were virtually unknown in Asia. But when, this year, a Korean translation of Unbearable Weight was published, I felt I needed to revisit the situation. I discovered multiple reports on dramatic increases in eating disorders in China, South Korea, and Japan. “As many Asian countries become Westernised and infused with the Western aesthetic of a tall, thin, lean body, a virtual tsunami of eating disorders has swamped Asian countries,” writes Eunice Park in Asian Week magazine. Older people can still remember when it was very different. In China, for example, where revolutionary ideals once condemned any focus on appearance and there have been several disastrous famines, “little fatty” was a term of endearment for children. Now, with fast food on every corner, childhood obesity is on the rise, and the cultural meaning of fat and thin has changed.

When I was young,” says Li Xiaojing, who manages a fitness centre in Beijing, “people admired and were even jealous of fat people since they thought they had a better life….But now, most of us see a fat person and think ‘He looks awful.’”

Clearly, body insecurity can be exported, imported, and marketed–just like any other profitable commodity. In this respect, what’s happened with men and boys is illustrative. Ten years ago men tended, if anything, to see themselves as better looking then they (perhaps) actually were. And then (as I chronicle in detail in my book The Male Body) the menswear manufacturers, the diet industries, and the plastic surgeons “discovered” the male body. And now, young guys are looking in their mirrors, finding themselves soft and ill defined, no matter how muscular they are. Now they are developing the eating and body image disorders that we once thought only girls had. Now they are abusing steroids, measuring their own muscularity against the oiled and perfected images of professional athletes, body-builders, and Men’s Health models. Now the industries in body-enhancement–cosmetic surgeons, manufacturers of anti-aging creams, spas and salons–are making huge bucks off men, too.

What is to be done? I have no easy answers. But I do know that we need to acknowledge, finally and decisively, that we are dealing here with a cultural problem. If eating disorders were biochemical, as some claim, how can we account for their gradual “spread” across race, gender, and nationality? And with mass media culture increasingly providing the dominant “public education” in our children’s lives–and those of children around the globe–how can we blame families? Families matter, of course, and so do racial and ethnic traditions. But families exist in cultural time and space–and so do racial groups. In the empire of images, no one lives in a bubble of self-generated “dysfunction” or permanent immunity. The sooner we recognize that–and start paying attention to the culture around us and what it is teaching our children–the sooner we can begin developing some strategies for change.

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This entry was posted on February 24, 2008 at 3:21 pm and is filed under article, eating disorder, eating disorders, men, real life experience, statistics. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

Newspapers around the world share similar headlines and stories about the increase incidences of eating disorders in their countries. An Israeli newspaper, Haaretz, cites, “Can too much healthy food hurt you?, ” covering a relatively new and controversial eating disorder, orthorexia. The Copenhagen Post online contains a story, “Models are still skinny,” discussing the lack of follow-through of the modeling industry to follow health guidelines. The Jakarta Globe of Indonesia posts an article “More Women Become ‘Fashion Victims’ As Eating Disorders Spread in Indonesia,” highlighting the increased awareness of and incidences of eating disorders in Indonesia.

International studies on eating disorders show that:

  • One percent of college-aged women in the U.S. have anorexia, while four percent of college-age women in the U.S. have bulimia1
  • 2.6 percent of female Norwegian students and 1.3 percent of Italian students have anorexia2
  • 1.2 percent of Cairo school girls and 3.2 percent of Iranian school girls have bulimia nervosa3
  • As few as 30% of people with EDs ever receive treatment for their illness, and in some communities that number is below 10%.”4

How are eating disorders impacted by globalization? Does media coverage increase the number of cases? Is Westernization of beauty ideals the main culprit behind the global spread of eating disorders? What can be done to combat eating disorders and who is responsible for monitoring progress and enforcing regulations?

What are eating disorders and how are they diagnosed

There are four main categories of eating disorders: anorexia nervosa; bulimia nervosa; binge eating disorder; and eating disorder not otherwise specified (EDNOS).

A relatively new eating disorder, coined orthorexia nervosa by Dr. Steven Bratman in 1997, is considered a “fixation on righteous eating.” Orthorexics are concerned not about the amount of food they consume, but about the quality of the food. They often refuse to touch sugar salt, caffeine, alcohol, wheat, gluten, yeast, soya, corn and dairy foods. In addition, they refuse to eat any food with pesticides, herbicides or artificial additives. They are proud of their eating habits and often become socially isolated. Most orthorexics are in the middle class and well educated. Some doctors believe orthorexia should be classified as a separate disorder and not just part of EDNOS.6 Doctors from around the world are starting to recognize the disease, including the U.S, United Kingdom, and Israel.

It is challenging to diagnose disorders across cultures, as rationales vary and do not always fit in with Diagnostic and Statistical Manual of Mental Disorders, one of two main tools (World Health Organization’s International Classification of Mental Health Disorders (ICD) is the other) used to diagnose the disease. For example, fatphobia is commonly cited as a main rationale for those suffering from anorexia; however, a study by the Prince of Wales Hospital (Hong Kong), Harvard Medical School, and Chinese University of Hong Kong found a lack of “fatphobia” amongst female anorexic patients in Hong Kong.7

Different countries and publication use different standards in their studies. Not all studies rely on clinical diagnosis, which further complicates international comparison.8

What causes eating disorders and why are they becoming more popular around the world

Researchers have documented psychological, biological, genetic, familial, and societal-level causes for eating disorders. Common causes include genetic predispositions, food aversions or cravings, “comorbidity” with other mood or personality disorders, abuse by a family member, cultural “fatphobia,” cultural body-type norms, and even state nutrition policies.9

Certainly many blame television and the Internet for the rise of easing disorders. A September 2, 2009 Wall Street Journal article, “Girls and Dieting, Then and Now,” notes, “today’s fourth-grade girls are barraged by media images of thinness. They can cruise the Internet visiting “Pro-Ana” (pro-anorexia) Web sites and can view thousands of “thinspiration” videos on YouTube celebrating emaciated young women.”10 The Wall Street Journal article though does not solely blame the media, “Parental fixations on weight, children’s urges toward perfectionism, family conflicts, and a $40 billion-a-year dieting industry can all lead girls to disorders.”11

A blog posting by Susan Bordo, Professor of Philosophy at the University of Kentucky and author of Unbearable Weight blames the rise of eating disorders around the world on the spread of western cultures and beauty ideals via mass media:

…the Fiji islands did not have access to television until 1995, when a single station was introduced It broadcasts programs from the United States, Great Britain, and Australia. Until that time, Fiji had no reported cases of eating disorders, and a study conducted by anthropologist Anne Becker showed that most Fijian girls and women, no matter how large, were comfortable with their bodies. In 1998, just three years after the station began broadcasting, 11 percent of girls reported vomiting to control weight, and 62 percent of the girls surveyed reported dieting during the previous months.12

Bordo further cites as article by Eunice Park in Asian Week,As many Asian countries become Westernised and infused with the Western aesthetic of a tall, thin, lean body, a virtual tsunami of eating disorders has swamped Asian countries.13 She decisively concludes, “we are dealing here with a cultural problem.”14

An Audrey Magazine (The Asian American Women’s Lifestyle Magazine) article notes that beauty standards in Korea changed after its media was open to foreign programming. Similar trends were found in Hong Kong, as women want “small breasts, small waists and Western facial features.” Often EDs are not discussed in Korea (and possibly other Asian cultures) because of the concept of shame, and the notion that problems should stay within the family.15

Political Scientist Dr. Kristen Edquist of Eastern Washington University describes how the theory of de-territorialization can be used to explain the spread of eating disorders. This method examines both the role of the person with the disorder as well as the diagnostician. Dr. Edquist believes that other theories (such as spread of Western media content) “miss the broader contexts and varied meanings of food refusal.”16

She postulates that the observer affect may account for increased diagnosis of EDs. Increased information about the diseases is easily accessible on the Internet and diagnosticians are increasingly collaborating on studies. She states that better diagnostic tools taking into account different cultures is needed.17

What can be done to combat eating disorders?

The Academy for Eating Disorders, a professional association for eating disorders professionals, has called upon governments and industry to support a ban against severely underweight models on the runway and in magazines. The Academy for Eating Disorders and the Brazilian Fashion Industry both have set similar guidelines for the fashion industry, including:

  • age threshold, physical and mental health parameters (such as BMI limits),
  • health monitoring for models and students who are aspiring models,
  • health promoting educational initiatives,
  • inclusion of models of varying weights and body types,
  • educational campaigns to raise awareness about photographic manipulation and,
  • establishment of collaborative channels with the government, eating disorders and eating disorders related organizations.

Brazil specifically got involved because there was a recent series of tragic deaths of Brazilian fashion models.18

Denmark’s’ Fashion Industry developed similar ethical guidelines in 2007; however, as of 2009, little has changed. A recent study shows that the fashion industry has ignored the guidelines. Denmark’s national society against eating disorders and self-mutilation (LMS) has proposed that models undergo an annual physical examination and that magazines should label all digitally altered photographs. LMS also wants to work with the government and civil society groups to start changing public ideals of body image. An estimated 75,000 Danes suffer from eating disorders.19

In Canada, hospitals and NGOs are pushing for more hospital staff on hand to treat eating disorders, who are multilingual. The Université du Québec en Outaouais in Gatineau and the Hopewell Eating Disorder Support Centre in Ottawa conducted an e-mail survey about eating disorders clinics in Eastern Ontario and West Quebec. The survey found that, “61 per cent of respondents believed a French-language eating disorders clinic was needed” and “41 per cent of those sampled would prefer to use French during treatment.”20 There is an estimated 8,400 people in French-speaking people in Ottawa, Gatineau and Eastern Ontario that have anorexia nervosa and bulimia.21

So far there have been few successful efforts led by national fashion councils to impose health and diet requirements on their models. Britain’s Fashion Council’s requirements for required doctor’s certificate of healthiness failed when other major fashion capitals did not follow their lead.22 Community and religious groups, as well as schools and hospitals are often at the front lines offering counseling and support groups, which provide much needed services for those suffering from EDs, but do not necessarily, stem the tide of new cases.

Conclusion

An 18 year old Irish woman has been lobbying the Irish government and Irish Internet Providers to ban pro-Anxoreia websites. The providers claim they cannot do anything until psychologists and the Irish government provides better guidelines.23

Should pro-eating disorder websites be classified similar to pornographic websites and other sites with harmful content? Where should the responsibility lie? Changing cultural attitudes and perceptions of weight and body image requires international collaboration of governments, industry, and community groups. Until they all work together, societal norms will most likely not change.


1 Edquist, Kristin. “Globalizing Pathologies? Eating Disorders and the Global Deterritorialization of Authority.” Paper presented at the annual meeting of the Western Political Science Association, Marriott Hotel, Portland, Oregon Online. 2009-05-26
2 Makino, Mariko, Koji Tsuboi, and Lorraine Dennerstein. “Prevalence of Eating Disorders: A Comparison of Western and Non-Western Countries.” MedScape Today. September 27, 2004.
3 Edquist, Kristin. “Globalizing Pathologies? Eating Disorders and the Global Deterritorialization of Authority.” Paper presented at the annual meeting of the Western Political Science Association, Marriott Hotel, Portland, Oregon Online. 2009-05-26
4 Sheppird, Sari. “Top 10 Facts You Need to Know About Eating Disorders.” Encyclopedia Brittanica Blog. August 25, 2009.
5 Edquist, Kristin. “Globalizing Pathologies? Eating Disorders and the Global Deterritorialization of Authority.” Paper presented at the annual meeting of the Western Political Science Association, Marriott Hotel, Portland, Oregon Online. 2009-05-26
6 Hill, Amelia. “Healthy food obsession sparks rise in new eating disorder.” The Observer. August 16, 2009.
7 Edquist, Kristin. “Globalizing Pathologies? Eating Disorders and the Global Deterritorialization of Authority.” Paper presented at the annual meeting of the Western Political Science Association, Marriott Hotel, Portland, Oregon Online. 2009-05-26
8 Makino, Mariko, Koji Tsuboi, and Lorraine Dennerstein. “Prevalence of Eating Disorders: A Comparison of Western and Non-Western Countries.” MedScape Today. September 27, 2004.
9 Edquist, Kristin. “Globalizing Pathologies? Eating Disorders and the Global Deterritorialization of Authority.” Paper presented at the annual meeting of the Western Political Science Association, Marriott Hotel, Portland, Oregon Online. 2009-05-26
10 Zaslow, Jeffery. “Girls and Dieting, Then and Now.” Wall Street Journal. September 2, 2009.
11 Ibid.
12 Bordo, Susan. The Globalization of Eating Disorders.
13 Ibid.
14 Ibid.
15 Haynie, Devon. “Feeding on Stereotypes.” Audrey Magazine. June 9, 2007.
16 Edquist, Kristin. “Globalizing Pathologies? Eating Disorders and the Global Deterritorialization of Authority.” Paper presented at the annual meeting of the Western Political Science Association, Marriott Hotel, Portland, Oregon Online. 2009-05-26
17 Ibid.
18 “Recommendations for the Brazilian Fashion Industry.” Academy for Eating Disorders.
19 “Models are still skinny.” The Copenhagen Post Online. September 2, 2009.
20 Rodgers, David. “French facility for eating disorders needed: report.” The Ottawa Citizen. September 2, 2009.
21 Ibid.
22 “Size zero. The debate.”
23 Murphy, Claire. “We can’t ban anorexia sites say web firms.” Herald. September 9, 2009.

* Picture sources: http://www.flickr.com/photos/katietegtmeyer/67863749/ and http://www.flickr.com/photos/quiltingmick/2251908028/

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